Organization
PHYSICIAN GROUPS LC
Active
Organization
PHYSICIAN GROUPS LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN CANTER-KOESTER (VP OPERATIONS AND STRATEGY)
(314) 996-7610
Entity
Organization
Contact information
Practice address
670 MASON RIDGE CENTER DR STE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504451907
—
MO
01
—
CC66523
MEDICARE RAILROAD
MO
Enumeration date
07/04/2006
Last updated
09/17/2025
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